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General NPI Number Information
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NPI Number | 1679791404
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Entity Type | Organization
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Legal Business Name | SILVER SUMMIT MEDICAL CORPORATION
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 08/16/2021
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Provider Practice Location Address
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Address Line | 1408 COMMERCIAL WAY
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0407
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Country | US
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Telephone | 661-327-4455
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 748792
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City | LOS ANGELES
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State | CA
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Zip | 90074-8792
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Country | US
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Telephone | 661-864-3664
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Fax | 661-328-2925
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Authorized Official
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Title or Position | DIRECTOR
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Name | MADELINE ANGELA MEYER
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Credential | PHD
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Telephone | 321-274-8344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A45356
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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